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General NPI Number Information
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NPI Number | 1033184718
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Entity Type | Organization
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Legal Business Name | CARDIOVASCULAR ASSOCIATES OF MOUNTAINSIDE PA
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Dates
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Enumeration Date | 02/17/2006
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Last Update Date | 09/21/2007
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Provider Practice Location Address
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Address Line | 1216 RTE 22 W
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City | MOUNTAINSIDE
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State | NJ
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Zip | 07092
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Country | US
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Telephone | 908-654-1200
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Fax | 908-654-1206
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Provider Business Mailing Address
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Address Line | 1216 RTE 22 W
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City | MOUNTAINSIDE
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State | NJ
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Zip | 07092
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Country | US
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Telephone | 908-654-1200
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Fax | 908-654-1206
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MS. GENIA DILIBERTI
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Credential |
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Telephone | 908-654-1200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | MB044592
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License Number State | NJ
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